Individual
DR. JEFFERY M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
304 W HAY ST, SUITE 215, DECATUR, IL 62526-6328
(247) 875-4263
(217) 872-5481
Mailing address
304 W HAY ST, SUITE 215, DECATUR, IL 62526-6328
(247) 875-4263
(217) 872-5481
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
0360982761
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360982761
—
IL
01
—
05832033
BLUE CROSS BLUE SHIELD
IL
01
—
388802
HEALTHLINK
IL
01
—
P00048412
RAILROAD MEDICARE
IL
Enumeration date
07/12/2006
Last updated
02/16/2009
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